Osteochondrosis of the thoracic spine refers to degenerative-dystrophic pathology. Problems with the ridge occupy the 5th place in the structure of all diseases of the musculoskeletal system. They are more common in people over the age of 45. Timely diagnosis and initiation of treatment make it possible to slow down the progression of the disease.
Development mechanism
Degenerative-dystrophic pathology, which includes osteochondrosis, is characterized by the presence of several main links of the pathological process, these include:
- Malnutrition (trophism) of the cartilage tissue, which occurs against the background of excessive load or exposure to other provoking factors, is called dystrophy.
- The gradual destruction of cells and intercellular substance of the cartilaginous tissue, which occurs as a result of malnutrition.
- The development of an inflammatory reaction, the severity of which depends on the degree of damage to the structures of the cartilage tissue.
- Violation of the functional state of the joint or the structure of the spine (intervertebral discs), which contains cartilaginous tissue.
Osteochondrosis involves the defeat of the intervertebral discs and joints of the processes of the ridge in various parts. The discs between the vertebrae are flattened, which leads to compression of the motor and sensory nerve fibers of the spinal roots. The mechanism of development of the disease is always accompanied by the addition of neurological symptoms.
Causes of the disease
Osteochondrosis of the thoracic ridge is a polyetiological disease. This means that the process of dystrophy and degeneration of cartilage tissue is triggered due to the influence of a large number of provoking factors:
- Hereditary predisposition, which determines the nutritional characteristics of the cartilaginous tissue with subsequent disturbances against the background of normal loads. In this case, osteochondrosis can develop in young people.
- Congenital malformations and anomalies in the development of the structures of the musculoskeletal system, leading to changes in blood flow in tissues and a deterioration in the nutrition of cartilaginous components.
- Postponed injuries of various parts of the ridge (fractures, bruises, dislocations and subluxations of the joints), which lead to a change in the ratio of various structures with the subsequent development of degenerative-dystrophic processes in them.
- Insufficient physical activity (sedentary lifestyle), leading to congestion in the tissues.
- Systematic increased loads on the thoracic spine (hard physical labor, prolonged static loads).
- Disruption of the metabolism of mineral salts in the body, which provokes a decrease in the strength of the bone processes, intervertebral discs and the subsequent malnutrition of the cartilaginous structures.
- Deterioration of the blood supply to the tissues of the spine, occurring against the background of compression of the main arteries or veins.
- Bad habits - nicotine and alcohol are vascular toxins that cause a deterioration in blood flow in tissues and a violation of their nutrition.
Finding out the reasons for the development of the pathological process is an obligatory component of the diagnostic process. This is necessary for the subsequent appointment of effective treatment, as well as the prevention of the re-development of osteochondrosis.
Symptoms of osteochondrosis of the thoracic spine
The development of the degenerative-dystrophic process is accompanied by the appearance and subsequent increase in the intensity of the following symptoms of osteochondrosis:
- Pain in the spine at the level of the chest - at first, pain appears after exertion, a long stay of the human body in one position. Then the sensations of discomfort intensify and become permanent. Often the pathological process is accompanied by a dull aching back pain between the shoulder blades.
- Unpleasant "squeezing" sensation in the back, which does not allow you to fully inhale.
- Violation of skin sensitivity in the form of numbness in various parts of the body (changes cover the skin of the upper or lower extremities on one side of the body) due to compression of the sensitive nerve fibers of the roots of the spinal cord.
- Muscle weakness in an arm or leg is usually on one side of the body.
- Violation of the functional state of the digestive system, which is accompanied by belching, heartburn, abdominal pain, flatulence (bloating), unstable stools.
- Changes in the back and arms, which include dry skin, increased brittleness of the nails (the result of a violation of the state of the autonomic nerve fibers when the spinal root is squeezed).
- Changes in the functional state of the pelvic organs, which is manifested by impaired urination, constipation, impotence in men, unstable menstrual cycle in women.
Manifestations appear gradually, a person cannot accurately indicate the time of their development. For a long time, the intensity of the symptoms increases, new signs of the pathological process are added. By the nature and duration of the sensations of discomfort in the back, there are 2 types of pain in osteochondrosis of the thoracic spine:
- Dorsago - pain manifests itself in the form of seizures that restrict movement in the back and interfere with taking a full breath.
- Dorsalgia is a constant aching pain localized in the area of the vertebrae affected by the pathological process.
Osteochondrosis of the thoracic spine is the cause of constant discomfort and a decrease in the quality of human life. Depending on the degree of changes, 4 stages of the development of pathology are distinguished:
- Stage 1 - minimal changes, increased mobility of the joints between the vertebrae, no symptoms.
- Stage 2 - protrusion (flattening) of the intervertebral disc, the appearance of slight pain, mainly after exertion.
- Stage 3 - the formation of a herniated disc, infringement of the spinal cord root, aching constant pains appear, neurological symptoms develop.
- Stage 4 - pronounced changes leading to severe constant pain, numbness of the skin in various parts of the body, a decrease in muscle strength, mainly in the upper limbs.
Determination of the stage of the course of the pathological process is carried out on the basis of the clinical manifestations of the disease. To clarify the nature and severity of changes, additional objective diagnostics are prescribed using imaging techniques of the spinal column.
Diagnostics
Based on the clinical picture, the doctor makes an initial conclusion. To determine the localization and nature of the change, as well as the stage of the pathological process, an additional examination is prescribed with visualization of the thoracic ridge:
- Spine X-ray is the most common method of instrumental diagnostics, which allows you to identify gross changes in the structures of the spine.
- Computed tomography is an X-ray technique of layer-by-layer tissue scanning, which has a high separation capacity and allows visualizing minimal changes in the thoracic ridge.
- Magnetic resonance imaging - for visualization, the phenomenon of resonance of the nuclei of compounds that occurs in a magnetic field is used. The technique involves scanning the body, while the human body does not experience radiation exposure.
To determine the functional state of various organs and systems, laboratory tests are prescribed (clinical, biochemical blood test, urine test). After the diagnosis, the doctor has the opportunity to choose the optimal treatment.
Treatment of osteochondrosis of the thoracic spine
Treatment of osteochondrosis of the thoracic spine is always complex. It is aimed at restoring the nutrition of the cartilaginous components, normalizing their properties, as well as the functional state of the vertebrae and roots of the spinal cord. For this, 2 main areas of therapeutic measures are used:
- Conservative treatment.
- Surgical invasive intervention.
Often, both directions of therapeutic measures are combined.
Conservative treatment
The basis of conservative treatment is the use of medications of several groups:
- Non-steroidal anti-inflammatory drugs - reduce the severity of the inflammatory response and pain.
- Adrenal hormones - Reduce inflammation and neurological pain.
- Muscle relaxants - drugs reduce the tone of the striated muscles in the spine, thereby reducing the compression of the roots of the spinal cord.
- Diuretics - means reduce tissue swelling and compression of the roots of the spinal cord due to increased excretion of urine.
- Chondroprotectors - reduce the severity of degenerative processes, destruction of cartilage tissue, contribute to its partial recovery.
- B vitamins - improve the course of metabolic processes in the nervous tissue, contribute to the early restoration of the functional state of the spinal cord roots.
- Vitamin C (ascorbic acid) - strengthens blood vessels, has an antioxidant effect (binds and inactivates free radicals, which are "fragments" of organic molecules with an unpaired electron and damage the membrane structures of cells).
During the period of remission (improvement of the condition and reduction of acute inflammatory phenomena), exercise therapy (physiotherapy exercises with special exercises), back massage, physiotherapy procedures (magnetotherapy, mud baths, electrophoresis) are prescribed. During the implementation of therapeutic measures, it is important to fulfill dietary (refusal from fatty fried foods, alcohol) and general (adequate sleep, rational work and rest) recommendations. Conservative therapy makes it possible to achieve a significant improvement in the condition.
Surgical interventions
In the absence of the necessary therapeutic result against the background of the use of medicines, in case of progression of the pathological process in order to radically eliminate the problems, an invasive surgical intervention is prescribed. It includes several techniques:
- Microdiscectomy - removal of a herniated disc with subsequent plasty of the hernial orifice.
- Foraminectomy - removal of bone outgrowths narrowing the canal in the area of the exit of the roots of the spinal cord.
- Laminectomy - dilation of the canal of the exit area of the spinal roots.
In modern hospitals, surgery is performed using minimally invasive endoscopic techniques. For the plastic opening of the hernial orifice, special meshes are usually used made of durable material that does not cause inflammatory reactions.
Prevention
To prevent the development of a pathological process, you need to follow several simple preventive recommendations, which include:
- Adequate eight hours of sleep.
- Limiting the impact of stress factors (chronic stress can provoke the development of pathological processes).
- Normalization of the regime of work and rest.
- Restriction of hard physical work.
- Rejection of bad habits.
- Rational nutrition with a sufficient intake of vitamins and vegetable fiber.
- Sufficient motor regime with dynamic exercises (charging), walking in the fresh air.
Osteochondrosis of the thoracic spine is characterized by a chronic progressive course. The disease requires long-term therapy, therefore it is easier and more accessible to prevent its development.